title: Cutaneous adverse drug reaction to oral acetazolamide and skin tests.
abstract: BACKGROUND
  Few cases of cutaneous adverse drug reactions (CADR) to oral acetazolamide, a non-antimicrobial sulfonamide, have been previously reported, and the interest of acetazolamide skin tests has never been studied.
  
  
  OBJECTIVE
  We report a series of ten patients with oral acetazolamide CADR and skin tests.
  
  
  METHODS
  The files of ten patients with CADR secondary to oral acetazolamide prescribed for cataract surgery in most cases referred between 2001 and 2011 in four French dermatology and allergy departments were retrospectively reviewed. Skin tests with acetazolamide were performed in nine patients and twelve controls. Other sulfonamides were tested in five of ten patients.
  
  
  RESULTS
  Seven patients developed maculopapular exanthema and four had acute generalized exanthematous pustulosis. Patch tests were positive for 8/9 patients, prick tests for 2/4 and intradermal tests for 3/3. Patch and prick or intradermal test results were concordant in 2/3 positive subjects. Patch tests for other sulfonamides were negative, as were patch tests in controls.
  
  
  CONCLUSIONS
  We report the largest series of CADR to oral acetazolamide (maculopapular exanthema or acute generalized exanthematous pustulosis). A drug eruption after cataract surgery should be investigated for accountability of acetazolamide. In view of this retrospective study, skin tests and particularly intradermal tests appear to be an important contribution to demonstrate accountability.
authors.affiliation: Department of Dermatology and Allergology, AP-HP, Hôpital Tenon, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Jachiet
authors.forename: N
authors.initials: N
authors.lastname: Bellon
authors.forename: H
authors.initials: H
authors.lastname: Assier
authors.forename: E
authors.initials: E
authors.lastname: Amsler
authors.forename: H
authors.initials: H
authors.lastname: Gaouar
authors.forename: C
authors.initials: C
authors.lastname: Pecquet
authors.forename: J L
authors.initials: JL
authors.lastname: Bourrain
authors.forename: E
authors.initials: E
authors.lastname: Bégon
authors.forename: O
authors.initials: O
authors.lastname: Chosidow
authors.forename: C
authors.initials: C
authors.lastname: Francès
authors.forename: S
authors.initials: S
authors.lastname: Ingen-Housz-Oro
authors.forename: A
authors.initials: A
authors.lastname: Soria
mesh_terms: D000086:Acetazolamide / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D006801:Humans; D007428:Intradermal Tests; D008875:Middle Aged; D010328:Patch Tests; D012189:Retrospective Studies; D013449:Sulfonamides / Q000009:adverse effects
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D013449:Sulfonamides; D000086:Acetazolamide